Dutch healthcare reform: did it result in better patient experiences in hospitals? a comparison of the consumer quality index over time

<p>Abstract</p> <p>Background</p> <p>In 2006, the Dutch hospital market was reformed to create a more efficient delivery system through managed competition. To allow competition on quality, patient experiences were measured using the Consumer Quality index (CQI). We study whether public reporting and competition had an effect on the CQI between 2006 and 2009.</p> <p>Methods</p> <p>We analyzed 8,311 respondents covering 31 hospitals in 2006, 22,333 respondents covering 78 hospitals in 2007 and 24,246 respondents covering 94 hospitals in 2009. We describe CQI trends over the period 2006-2009. In addition we compare hospitals that varied in the level of competition they faced and hospitals that were forced to publish CQI results publicly and those that were not. We corrected for observable covariates between hospital respondents using a multi level linear regression. We used the Herfindahl Hirschman Index to indicate the level of competition.</p> <p>Results</p> <p>Between 2006 and 2009 hospitals showed a CQI improvement of 0.034 (p < 0.05) to 0.060 (p < 0.01) points on a scale between one and four. Hospitals that were forced to publish their scores showed a further improvement of 0.027 (p < 0.01) to 0.030 (p < 0.05). Furthermore, hospitals that faced more competition from geographically close competitors showed a more pronounced improvement of CQI-scores 0.004 to 0.05 than other hospitals (p < 0.001).</p> <p>Conclusion</p> <p>Our results show that patients reported improved experiences measured by the CQI between 2006 and 2009. CQI levels improve at a faster rate in areas with higher levels of competition. Hospitals confronted with forced public publication of their CQI responded by enhancing the experiences of their patients.</p

Being Trusted: How Team Generational Age Diversity Promotes and Undermines Trust in Cross-Boundary Relationships

We examine how demographic context influences the trust that boundary spanners experience in their dyadic relationships with clients. Because of the salience of age as a demographic characteristic as well as the increasing prevalence of age diversity and intergenerational conflict in the workplace, we focus on team age diversity as a demographic social context that affects trust between boundary spanners and their clients. Using social categorization theory and theories of social capital, we develop and test our contextual argument that a boundary spanner’s experience of being trusted is influenced by the social categorization processes that occur in dyadic interactions with a specific client and simultaneously, by similar social categorization processes that influence the degree to which the client team as a whole serves as a cooperative resource for demographically similar versus dissimilar boundary spanner-client dyads. Using a sample of 167 senior boundary spanners from the consulting industry, we find that generational diversity among client team members from a client organization undermines the perception of being trusted within homogeneous boundary spanner-client dyads while it enhances the perception of being trusted within heterogeneous dyads. The perception of being trusted is an important aspect of cross-boundary relationships because it influences coordination and the costs associated with coordination

Lost in light

“Lost in light” is a musical reflection or meditation on “I am not yours” by American poet Sara Teasdale (1884-1933). The work was commissioned and premiered by Plexus in the Melbourne Recital Centre on 24 November 2014

SUMMARY

A prospective randomized double-blind study was conducte